An international research group consisting of 19 scientists from Germany, the U.K., Italy, the United States and Ukraine has published the results of a study of the effectiveness of the drug Amizon (active compound enisamium iodide) in the treatment of COVID-19 disease. The trials were carried out in-vitro (in laboratory). Its results are published on the Medrxiv website, which belongs to the Cold Spring Harbor Laboratory (the United States) and it is the world’s main resource providing open access to the results of research on COVID-19.
In their article, scientists from Institute of Medical Virology, University Hospital Frankfurt, Goethe University described for the first time the antiviral effect of Amizon against SARS-CoV-2. The co-authors of the article, scientists from Oxford and Cambridge Universities, have revealed the mechanism of action of the drug, which consists in inhibiting the viral RNA polymerase, under the influence of which the virus multiplies.
The results of the study made it possible to start the third stage of clinical trials of the drug in Ukraine. In May 2020, a multi-centre, randomized, double-blind, placebo-controlled study of the efficacy and safety of Amizon Max was launched. In the course of the study, the use of Amizon was combined with basic treatment of patients with moderate severity of COVID-19 infection.
The trials were carried out in parallel in several clinics in different cities of Ukraine. Specialists from Germany were involved in the study.
Intermediate results of the third stage of clinical trials of Amizon demonstrated its effectiveness in patients requiring non-invasive oxygen support (without the use of a ventilator). In particular, at this stage of the study, Amizon showed itself as a drug that accelerates the onset of a significant improvement in the condition of patients on average up to three days.
At the same time, to confirm or refute the positive trend, an additional recruitment of patients is currently being carried out to continue clinical trials. Final results are expected at the end of February.
The program “Treatment of Ukrainian citizens abroad” in the long term should be reduced to isolated cases, economist at the CASE Ukraine analytical center, author of a study on the implementation of the program and identification of more effective ways of state financing Natalia Leschenko has said.
“The program needs to be abandoned in the short term, but it requires tight budget constraints and prioritization of referrals for treatment (for example, referral to treatment of children, patients who have a high chance of returning to normal life). In the long term, the program needs to be reduced to isolated cases,” she said during a presentation of the study results on Tuesday.
Leschenko also said that it is necessary to introduce an assessment of the quality of such treatment.
“What would ideally like to see is an assessment of the patient’s health outcomes after treatment. The comparison of these results with the reference ones established on the basis of scientific research and clinical evaluations. This requirement is in the legislation of other countries that treatment abroad should be paid for at the state expense, only if this treatment is proven to be effective. Examples include readmission rates, mortality, complications,” she said.
“Our proposal is, in principle, not to increase funding for the program. The governments of most countries adhere to the principle of limited funding, that is, payment of a percentage of treatment or full payment to a limited number of people,” the expert said.
As reported, under the budget program “Treatment of Ukrainian citizens abroad” in 2020, UAH 1.089 billion is provided.
The Ministry of Health of Ukraine has created a separate unit, whose task will be the transplantation and treatment of Ukrainian patients abroad, the press service of the Ministry of Health reported on the Telegram channel.
“I want the number of Ukrainian patients who are being treated abroad to constantly decrease. I want them to be treated in Ukraine, to develop transplantation in Ukraine. We have everything for this. The main thing is that we have specialists who can transplant. We just need to create a certain system that would allow this to be done in Ukraine. We are doing this now,” Minister of Health Maksym Stepanov said at a daily briefing.
Pharmaceutical manufacturers of Ukraine register clinical trials of medicines for the treatment of coronavirus (COVID-19), Health Minister Maksym Stepanov has said.
“There are internal enterprises that register clinical trials of medicines, which they produce in our country. Currently, they are Farmak, Borschahivsky Chemical Pharmaceutical Plant, Darnitsa pharmaceutical company, Biopharma and Interchem. They are trying to create medicines to treat COVID-19, including symptomatic ones. For example, Darnitsa brought in a substance for the production of hydroxychloroquine, while Biopharma registered a clinical trial of Bioven,” he said during a press briefing in Kyiv on Wednesday, May 13.
It will become possible to resume treatment of Ukrainians abroad as soon as non-emergency care clinics open. All patients receive healthcare services at specialized clinics in Ukraine, Deputy Health Minister of Ukraine Iryna Mykychak told a press briefing in Kyiv on Thursday.
“There are patients who require medical services that are not available in Ukraine. This is, first of all, bone marrow transplant. The national budget provides for funds for treatment of such patients in foreign clinics. A standing commission, which makes decisions on referrals to treatment, is working. Currently foreign clinics are closed for non-emergency patients. As soon as they open, patients will be able to receive aid. Today they receive healthcare services at specialized clinics in Ukraine,” she said.
Ukrainian citizens preferred receiving treatment for oncology and cardiac diseases abroad in 2019, just as a year earlier. Foreign specialists point at poor quality of medical documents which patients bring from the post-Soviet countries.
International medical tourism operators voiced such conclusions to Interfax-Ukraine after having analyzed the medical tourist flow to foreign clinics.
According to the Ukrainian Association of Medical Tourism (UAMT), around 160,000 patients left Ukraine for treatment in 2018. Germany, Israel and Turkey were the most popular destinations for medical tourism from Ukraine. During the same time, around 65,000 foreign patients came for treatment to Ukrainian clinics.
Director of the medical tourism agency DeutschMedic GmbH Anna Weegen (Essen, Germany) said that in 2019 almost a half of foreign patients of German clinics were diagnosed with cancer: breast cancer took the lead, esophagus, stomach and colorectal cancer ranked second, lung cancer ranked third. Around one third of foreign patients addressed German clinics for treatment of cardiac diseases and for replacement of arthroplasty.
“High-technology operations are in demand, including robot-assisted surgery and combined therapy for life-threatening diseases,” she said.
Weegen praised the visa-free regime which allows patients to receive medical aid in Germany promptly.
“That is what helped us in 2019 rapidly provide some patients with serious diseases with aid and organize transportation of their relatives,” she said.
Weegen also said that in general the cost of healthcare services in Germany for foreign patients did not change in 2019 for both check-ups and in-patient treatment as it is regulated in Germany in line with the DRG (Diagnosis Related Group) system.
At the same time, an increase in the cost of some kinds of treatment in Germany was caused by the active introduction of new expensive medicines, in particular drugs for targeted therapy for oncology diseases or materials for minimally invasive heart valve surgeries.
Weegen added that in 2019 German clinics and medical tourism operators still received poor quality medical documents from patients.
“We often receive odd handwritten medical reports and poor quality medical images,” she said.
In turn, expert for organization of treatment in Germany Dmitry Ladizhenski (Berlin) also said that the cost of treatment for foreign patients “have been remaining mainly at the same level for many years despite the fact that the price list based on the DRG is regularly updated.” The DRG pricing system significantly facilitates the healthcare budgeting and mutual payments between the government, insurance companies and hospitals.
Ladizhenski also said that the number of patients from Ukraine has increased, which is related, first of all, to the cancelation of visas between the EU and Ukraine.
“Up to 80% are oncology patients,” he said.
In turn, Director General of the foundation Proturmed Mariusz Arent (Gdansk, Poland) said that the number of Ukrainian patients in Polish clinics tripled, to around 10,000 people, in 2019. However, this became possible mainly due to an increase in the number of Ukrainian migrants in Poland.
Arent noted that, according to the Institute of Research and Development of Medical Tourism (Poland), the total number of medical tourists in Poland was around 182,000 people in 2018. He added that Ukrainian patients travel to Poland for treatment of oncology, orthopedic surgery, cardiac diseases and rehabilitation after injuries.
According to Arent, the cost of treatment in Poland for foreign patients did not change in 2019, although in general prices in Polish private clinics usually exceed Ukrainians’ budgets.
Board Member of the Lublin Medicine Cluster Management Marzena Strok-Sadło (Poland) reported that, in 2018 only, 15 providers of medical services (12 private clinics and three state hospitals in Lublin) received 5,787 foreign patients, the majority of whom arrived from the UK and Ukraine.
She added that foreign patients traveled to Lublin mainly for treatment of gynecology, oncology, orthopedic, ophthalmology diseases and for obstetric care. In addition, Polish stomatology, rehabilitation, aesthetic medicine and plastic surgery services are popular among foreign patients. Ukrainians also often visit SPA resorts in Poland. As to the price policy, the expert said that the cost of medical services in Poland rose by 5-6% in 2019.
In turn, Board Chairman of the Turkish Association of Medical Tourism Emin Çakmak (Turkey) said that in general Turkey receives around $10 billion from medical tourists from 165 countries. Around 1 million foreign medical tourists annually visit Turkey, around 45,000 of them were Ukrainians in 2019. The number of Ukrainian patients in Turkey annually grows by 10-15%. The majority of Ukrainian patients travel to Turkey for treatment of oncology diseases and for pediatric rehabilitation.
“Turkey is becoming the most preferred destination for Ukrainian medical tourists. Turkish clinics actively organize their work for this growing flow, for example many hospitals hire Ukrainian citizens who help Ukrainian patients to communicate with Turkish doctors,” he said.